Expanded Precautions

Expanded Precautions are used when Standard Precautions don’t provide enough protection from, or control of, an infectious disease. They are used when dealing with highly transmissible or epidemiologically important pathogens.

Epidemiologically important pathogens are infectious agents that have one or more of the following characteristics: 

  1. Easily transmitted and the occurrence of clusters of two or more infected individuals in one (healthcare) setting. 
  2. Antimicrobial resistance. 
  3. Associated with serious clinical disease, increased morbidity and mortality . 
  4. A newly discovered or reemerging pathogen. 

Expanded Precautions relate to the main routes of transmission: 

  • Airborne Precautions 
  • Droplet Precautions 
  • Contact Precautions 
These precautions may be combined for diseases that have multiple routes of transmission. They are used in addition to Standard Precautions. 
  • Airborne Precautions: Airborne Precautions reduce the risk of airborne transmission of infectious agents. Microorganisms carried in this manner can be dispersed widely by air currents. They may be inhaled by or deposited on a susceptible host within the same room or over a longer distance from the source patient. Therefore, special precautions such as personal respiratory protection and special air handling and ventilation are needed to minimize the spread of the disease. 
  • Droplet Precautions: Droplet Precautions reduce the risk of droplet transmission of infectious agents. Droplet transmission involves contact with contaminated large-particle droplets through the susceptible person’s eyes, nose or mouth. Transmission via large-particle droplets requires close contact between source and recipient persons. Precautions usually include use of surgical masks or face shields when in close proximity to the infected person. 
  • Contact Precautions: Contact Precautions reduce the risk of disease transmission by direct or indirect contact. Direct-contact transmission involves skin-to-skin contact and physical transfer of organisms from an infected person to another person. Indirect-contact transmission involves contact with a contaminated object, usually located in the infected person’s living or healthcare environment. Masks, gowns, and gloves are typically used to reduce contact transmission risks. Use of disinfectants and decontamination procedures minimize the risk of spreading the infection.